Aortic valve neocuspidization using bovine pericardium for prosthetic valve endocarditis in a hemodialysis patient.

BACKGROUND

Hemodialysis patients are at high risk for prosthetic valve endocarditis (PVE) because of the risk of bacteria entering with each hemodialysis session. To avoid the use of artificial materials as much as possible, we performed aortic valve neocuspidization (AVNeo) using bovine pericardium.

CASE PRESENTATION

A 67-year-old patient had undergone aortic valve replacement using a bioprosthetic valve 4 months previous. For the past month, he had had PVE caused by Candida glabrata. Because the pericardium had already been incised in the previous surgery and there was not enough pericardium left for neocuspidization, we performed AVNeo using bovine pericardium. The previously implanted bioprosthetic valve revealed sticky fungal warts on the leaflet and valve ring, which prevented the movement of the valves. We cut all of the threads holding the valve and removed the bioprosthetic valve. Three valves were cut from the bovine pericardium using a unique template following the method of Ozaki et al. and were fixed to the valve ring with a running suture. The postoperative course was good.

CONCLUSIONS

We believe that this treatment is an effective method for PVE because we can avoid the use of artificial materials as much as possible.